Provider Demographics
NPI:1447229588
Name:KUMAR, NEELAM B (MD)
Entity type:Individual
Prefix:
First Name:NEELAM
Middle Name:B
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 32615
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48232-0615
Mailing Address - Country:US
Mailing Address - Phone:313-593-7965
Mailing Address - Fax:313-593-7143
Practice Address - Street 1:33155 ANNAPOLIS AVE
Practice Address - Street 2:ANNAPOLIS HOSPITAL
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-2405
Practice Address - Country:US
Practice Address - Phone:734-467-4000
Practice Address - Fax:734-467-6691
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI037679207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4242725Medicaid
MI220014016OtherRR MCR